Jerome H. Levy, M.D. Bronx, NY
President & Chairman of the Board, VCNA
Approximately four years ago, while attending a Becker’s ASC Meeting, I was introduced to the concept of a government-approved entity known as a Clinically Integrated Network or CIN. It was being used in the context of hospitals and physician practices and I thought, "Why not for ambulatory surgery centers?"
In the Fall of 2013, I began to correspond with colleague-owners of successful ophthalmic ASCs. Glenn deBrueys, CEO of American SurgiSite, Inc., a management company of nine ASCs in the greater New York and New Jersey area, was in my office the next day ready to start. This was the beginning of the formation of the Vision Center Network of America, LLC.
To coalesce in multiple meetings and choose a CIN Consultant took our group of ASCs about a year -- which then became the Fall of 2014. The CIN Consultant we chose, The Coker Group, assessed each ASC’s operational and economic factors; and we reviewed the legalities of forming a CIN with two law firms.
The formation and adoption of VCNA's Business Plan took another year, which brought us to the Fall of 2015. All of the above required our cost, time and energy. So at that time, the ASCs met to ask each other, “Should we operationalize?” The answer was a unanimous "Yes."
We envisioned 5 major purchasers of VCNA's services: Government, Employers as well as acronyms such as ACOs, commercial entities, and hospitals. As a network of ASCs, the VCNA could now offer a much more compelling value proposition to our Payor entities and suppliers than each of our ASCs could do on their own.
We maintained two fundamental elements throughout all of our development:
1. Each ASC member must keep its own individual and separate identity, and
2. As a CIN, our goal was to reduce ASC expenses, create negotiating opportunities with Payors, and advance quality of services through benchmarking.
We worked on establishing management, administrative and IT infrastructures. We applied the Care Process Design System established by Coker Group to collate and utilize data. To meet our goal, we intended to form an entity that could respond to all Payors and be able to negotiate with all from a position of strength with patient care and value of primary importance.
We formed a Board of Managers and an Executive Committee to supervise strategy and operations and, through our Working Group, with Coker's guidance, created an operational Network after conducting bi-weekly conference calls/meeting for about a year.
Legal compliance was profoundly important for anti-trust reasons, and compliance issues were reviewed diligently through the services of the law firm of Garfunkel Wild, P.C.
VCNA's main focus was to become pro-competitive -- to provide quality care at lower cost. This would be achieved through continual mandatory training and comparison and improvement through the utilization of the best practices of VCNA's member surgery centers. This vital benchmarking effort with reportable IT results would ensure VCNA's survival, profit and legal compliance.
Based on our experience, VCNA's CIN is a reasonable alternative for ophthalmic ASCs to prepare for the future -- a future that is already banging on our doors. Mergers of hospitals and practices, and hospitals purchasing practices are all occurring rapidly. Some hospital centers are even creating their own insurance entities and controlling patient points of care. ASCs also need to ally to remain competitive. To remain successful, they must have a seat at the table in this future health care world, where fee-for-value is replacing fee-for-service more and more.
In this past year, VCNA has operationalized as follows:
1. Membership Benefits
2. Group Purchasing Organization
3. Inventory Control Software
4. Payor Contract Analytics and Negotiations
I look forward to the expansion of VCNA to include additional ASCs in the near future and I will keep you informed of our progress over the next months and years.